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MR findings of steatotic focal nodular hyperplasia and comparison with other fatty tumours

  • Hepatobiliary-Pancreas
  • Published:
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Abstract

Objectives

To correlate MR findings with pathology in steatotic FNHs and to compare the MR findings with those of other fatty tumours developed on noncirrhotic liver in a consecutive series of resected lesions.

Methods

Our population included resected FNH with intralesional steatosis (n = 25) and other resected fatty tumours selected as controls (hepatocellular adenomas and angiomyolipomas, n = 34). Lesions were classified into three groups: those with typical FNH without (group 1) or with (group 2) fat on MR and those with atypical lesions (group 3). In group 3, diagnostic criteria for other fatty tumours were applied.

Results

There were 9 lesions in group 1 (15.3 %), 4 in group 2 (16.8 %) and 46 in group 3 (77.9 %). Group 3 contained 12 FNHs (26 %) and all the other fatty tumours. In group 3, the association of lesion homogeneity, signal intensity similar to or slightly different from adjacent liver on in-phase T1- and T2-weighted sequences, and strong arterial enhancement was observed in 7/12 (58 %) of steatotic FNHs and 3/34 (9 %) of other tumours.

Conclusion

On MR, fat within a typical FNH should not reduce the diagnostic confidence. We recommend further investigations including liver biopsy if necessary when fatty tumours exhibit atypical MR findings.

Key Points

• MRI is increasingly used to assess hepatic lesions containing fat.

• Nodules of focal nodular hyperplasia often contain foci of fat.

• However, steatotic FNH does not always demonstrate typical fatty features on MRI.

• The main mimickers of steatotic FNHs are telangiectatic/inflammatory hepatocellular adenomas.

• We recommend liver biopsy when fatty tumours exhibit atypical MR findings.

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Abbreviations

FNH:

Focal nodular hyperplasia

HCA:

Hepatocellular adenoma

LFABP:

Liver fatty acid-binding protein

SAA:

Serum amyloid A

GS:

Glutamine synthetase

MRI:

Magnetic resonance imaging

H&E:

Haematoxylin-eosin

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Authors and Affiliations

  1. Department of Radiology, University Paris Diderot, Sorbonne Paris Cité, University Hospitals Paris Nord Val de Seine, Beaujon, 100 bd General Leclerc, 92118, Clichy, Hauts-de-Seine, France

    Maxime Ronot, Rafael Duran, Anne Kerbaol, Marie-Pierre Vullierme & Valérie Vilgrain

  2. INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, CRB3, Paris, France

    Maxime Ronot, Valérie Paradis, Dominique-Charles Valla & Valérie Vilgrain

  3. Department of Pathology, University Paris Diderot, Sorbonne Paris Cité, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France

    Valérie Paradis

  4. Department of Surgery, University Paris Diderot, Sorbonne Paris Cité, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France

    Jacques Belghiti

  5. Department of Hepatology, University Paris Diderot, Sorbonne Paris Cité, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France

    Dominique-Charles Valla

Authors
  1. Maxime Ronot
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  2. Valérie Paradis
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  3. Rafael Duran
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  4. Anne Kerbaol
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  6. Jacques Belghiti
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  7. Dominique-Charles Valla
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  8. Valérie Vilgrain
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Correspondence to Maxime Ronot.

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Ronot, M., Paradis, V., Duran, R. et al. MR findings of steatotic focal nodular hyperplasia and comparison with other fatty tumours. Eur Radiol 23, 914–923 (2013). https://doi.org/10.1007/s00330-012-2676-y

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  • DOI: https://doi.org/10.1007/s00330-012-2676-y

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